{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:23:43Z","timestamp":1791433423306,"version":"4.3.3"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007458","name":"Deutschen Multiple Sklerose Gesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007458","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Progression prediction is a significant unmet need in people with progressive multiple sclerosis (pwPMS). Studies on glial fibrillary acidic protein (GFAP) have either been limited to single center with relapsing MS or were based solely on Expanded Disability Status Scale (EDSS), which limits its generalizability to state\u2010of\u2010the\u2010art clinical settings and trials applying combined outcome parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum GFAP and NfL (neurofilament light chain) were investigated in EmBioProMS participants with primary (PP) or secondary progressive MS. Six months confirmed disability progression (CDP) was defined using combined outcome parameters (EDSS, timed\u201025\u2010foot walk test (T25FW), and nine\u2010hole\u2010peg\u2010test (9HPT)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      243 subjects (135 PPMS, 108 SPMS, age 55.5, IQR [49.7\u201361.2], 135 female, median follow\u2010up: 29.3\u2009months [17.9\u201340.9]) were included. NfL (age\u2010) and GFAP (age\u2010 and sex\u2010) adjusted\n                      <jats:italic>Z<\/jats:italic>\n                      scores were higher in pwPMS compared to HC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both). 111 (32.8%) CDP events were diagnosed in participants with \u22653 visits (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009169). GFAP\n                      <jats:italic>Z<\/jats:italic>\n                      score &gt;3 was associated with higher risk for CDP in participants with low NfL\n                      <jats:italic>Z<\/jats:italic>\n                      score (i.e., \u22641.0) (HR: 2.38 [1.12\u20135.08],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025). In PPMS, GFAP\n                      <jats:italic>Z<\/jats:italic>\n                      score &gt;3 was associated with higher risk for CDP (HR: 2.88 [1.21\u20136.84],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Risk was further increased in PPMS subjects with high GFAP when NfL is low (HR: 4.31 [1.53\u201312.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Blood GFAP may help identify pwPPMS at risk of progression. Combination of high GFAP and low NfL levels could distinguish non\u2010active pwPMS with particularly high progression risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.51969","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T05:33:57Z","timestamp":1702964037000},"page":"477-485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Serum glial fibrillary acidic protein and disability progression in progressive multiple sclerosis"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9731-4169","authenticated-orcid":false,"given":"Ahmed","family":"Abdelhak","sequence":"first","affiliation":[{"name":"Department of Neurology University of California San Francisco (UCSF)  San Francisco California USA"},{"name":"Department of Neurology University Hospital of Ulm  Ulm 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Havla","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neuroimmunology, LMU Hospital Ludwig\u2010Maximilians University  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe K.","family":"Zettl","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroimmunological Section University of Rostock  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Kleiter","sequence":"additional","affiliation":[{"name":"Marianne\u2010Strau\u00df\u2010Klinik Behandlungszentrum Kempfenhausen f\u00fcr Multiple Sklerose Kranke gGmbH  Berg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Skripuletz","sequence":"additional","affiliation":[{"name":"Department of Neurology Hannover Medical School  Hanover 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Biomedicine University Hospital and University of Basel  Basel Switzerland"},{"name":"Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Department of Clinical Research University Hospital and University of Basel  Basel Switzerland"},{"name":"Department of Neurology University Hospital and University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-8892","authenticated-orcid":false,"given":"Jens","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Department of Biomedicine University Hospital and University of Basel  Basel Switzerland"},{"name":"Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Department of Clinical Research University Hospital and University of Basel  Basel 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